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AFOF had been on Oxymorphone 15mg ER once in morning,once at bedtime for supposed extended relief from pain and then she is on 4 Percocet 10/325 during the day time. This has not been giving her the pain relief she needs-is actually almost unnoticeable pain relief. She has went to far as to insufflate 1/4 of one of the Oxymorphones 3-4 times per day rather than take orally as when she takes them orally, even if chewing them up, she experiences absolutely no relief from the pain. During the day time she takes 2 of the Percocets twice daily receiving only a bare minimum of pain relief.
Prior to seeing the pain management doctor she sees now, she had been on 6 Oxycodone 15mgs per day. Those worked so well for her than sometimes she had no need to take the entire amount per day she had been prescribed.
She wants to plead with this pain management doctor to be put back on the Oxycodone's, however she is concerned that since she had been taking 2 of the 10/325 mg Percocet at a time, that maybe she should ask for 20 mg Oxycodone (if they even exist) or if going back to the 15 mgs the Oxycodone's would work as they did before.
Thanks for any advice you may have!
PS: The pain management doctor keeps trying to up her dose of Oxymorphone however higher doses of the extended release are impossible to insufflate, therefore she would not receive any additional pain relief from higher doses since she must insufflate the Oxymorphone ER 15mg to begin with.

Insufflating 1/4 of an oxymorphone (Opana 15 mg. pill) raises the bioavailability of the "roughly" 3.76 mg. (a quarter of the pill) dosage by about 40-45%%, compared to 10% bioavailability when taken orally. I'm sure you can feel a major difference between the oral dose and the insufflated dose, but isn't doing so really flying in the face of good judgement?

I mean your tolerance is bound to grow and your physician could sooner or later (probably sooner) figure out that your dosing improperly, via urine analysis, or by your running out of meds? And there is also the Percocet to take into account as well. It all adds up quick.

I'm a chronic pain patient and know how carefully pain management physicians watch over their charges. Are you at all concerned of being let go by your doctor? Did you sign a standard pain contract, like I did? You really need to have a Come To Jesus meeting with your physician and be honest about your continuing pain.

Also, may I ask what exactly is the doctor treating you for, and how long have you been on opiates all together?

Post Quality Evaluations:

Thoughtful post

Last edited by Beenthere2Hippie; 29-10-2013 at 02:58.
Reason: adding copy

Apologies for spelling errors. Roxy/oxycottin (oxycodone) instead of percocet (acetominophen/oxycodone) I've found can relieve much more pain but should be used as carefully as its not cut with Acenomenophen and hits alot harder than percocet. I really rather advise low dose oxycodone besides percocets as you probley know it burns less when insufflated which is not illegal to do in parts of america with your perscriptions and doesn't have tylenol (most of the nasal burn in percocet) which is absolute liver torture, and in abuse or overdose situation the tylenol in percocet can kill your liver in one go, also straight oxycodone works better. I highly suggest you talk to your doctor about continuing oxymorphone with straight oxycodone as it can increase risks and side-effects. Lowdose oxycodone or even mid-dose would deffinately work better if used right. Unless youre in crippling pain try to stay away from high dose anything.

To: Beenthere2Hippie I will attempt to answer your questions which may give you a bit better understanding of the situation. My best friends friend is prescribed 2 Opana ER 15mg per day-1 to be taken of the morning 1 to be taken at night for supposed extended relief from pain. Is also prescribed 4 10/325mg Percocet to take during the day time for pain. She suffers from extensive spinal degeneration from arthritis, bulging and ruptured discs from thoracic area down to and including the lower lumbar area which is partially cutting off the sciatic nerve on her left side and not as bad but also doing same on the right side. In addition to the back problems she also suffers from severe arthritis of the knees, fibromyalgia and probably other things I can't seem to bring to mind at the moment. She is partially wheel chair/walker bound already.
Besides the pain meds is also having many types of injections in the spine for the past yr on a almost monthly basis which do not seem to be helping even a small bit. The physicians idea was to give the pain meds and use these spinal injections to hopefully stave off surgery for a few more yrs.
She has been on some type opiate since 2005 but thankfully is not addicted--I've seen her go off of her meds (usually due to the inability to pay for them) for weeks at a time and although she suffered pain, she did not whack out like many do who are truly addicted to opiates. I've been told she actually goes off her pain meds every 2-3 months for a few weeks at a time to be assured she is not becoming dependent.
Back to this pain doctor. He seems to push the same medications to all of his patients as she said she had listened in on conversations while in the waiting room with people comparing their medications. She also said this pain doctor seems to "push" people into having these injections and has not met one patient whom says they injections truly work for them.
As for the pain injections, she is diabetic and prior to beginning these injections, her blood sugar was so stable, she rarely needed to even take a blood sugar pill, but since beginning these injections, her sugar has went way out of control and she says it seems just as she gets it under control again, it is time for another spinal injection and the whole circle starts again.
She was on Norco 10/325 from 2005-2011. By 2011 they were not helping so her regular physician put her on Oxycodone 15mg 6 per day. She states those really did help with the pain and often times she had no need to take all she was allotted to take each day. She was on those for apx one yr, then rules changed and she was sent to a pain doctor. This pain doctor immediately cut her Oxycodone down to 10mg and placed her on fentanyl patches. The patches did not help and she had a lot of trouble keeping them on as she has a sweating problem and they would just slide off. This doctor upped the fentanyl to 75mg yet they still did not help and the straw that broke the camels back was one of these patches fell off and she could not find it. She has many pets as well as grandchildren and was horrified that one might find the patch and die from touching it or ingesting it. This pain doctor did not want to change the plan so she was forced to seek out another specialist the one whom she is with now.
I asked again a few days ago how she was taking her meds. She stated that she insufflates 2 quarters of one Opana ER 15mg per day and takes her percocets as normal--I had misunderstood just how much she was insufflating of the Opana. So she is actually taking less of the Opana that she is prescribed. She has been doing this for several months and has a 16 panel U/A every visit and the doctor has not mentioned anything amiss. BTW she did have a major talk with her doctor concerning the pain meds just not cutting it, but he didn't seem to really pay attention to what she was saying and began talking about even more injections. FYI the state of Oklahoma,which we are in, just began some serious changes in pain pill laws so we all believe this is one of the reasons her doctor is not jumping to try some different pain medication with her at this time. I do want to add she mentioned she is ultimately seeking to have a spinal cord stimulater in hopes this would reduce or obliterate her need for any pain pills.
Sorry for the long post but did want you to understand this is a woman in her 50s, not a young person and is truly seeking pain relief not a high. Also do appreciate your thoughtful response
Kindest Regards
ToastnJam

toastnjam added 8 Minutes and 40 Seconds later...

To drummingstoned20 Thanks for the thoughtful information, however I do not believe this woman has ever insufflated any kind of meds until recently with the Opana ER 15, in quarters. As I mentioned previously, she was on Oxycodone 15mg for over a yr and they did take care of her pain so well she states often times she did not need to take all of the 6 allotted pills per day. What she is wanting to know, is now that she has been taking Percocet 10s, two at a time to get any pain relief as only one percocet does nothing now, if when she asks her pain management doctor if she can go back on the Oxycodone, if she should ask for 20mg instead of the 15mg she had been on--due to having been taking two at a time of the percocets which are basically same thing as oxycodone, just without the tylenol in them. She's just concerned she might have developed a slight tolerance to the drug and may need a bit higher dose to work now days.
Thanks again for your input!!!
Kindest Regards,
ToastnJam

Last edited by toastnjam; 14-11-2013 at 02:41.
Reason: Automerged Doublepost

I don't think it's just the Perocet you have to be worrying about changing. If you are finding that you need to insufflate your ER medicine to get relief, then that must be changed as well. If your doctor does not want to change it despite the fact it is not helping when taken as intended, then find a doctor who will listen to you.

Most pain management doctors aim to have patients on enough long acting medicine to not need so much breakthrough medication, though the size of dose and frequency will of course vary from doctor to doctor and patient to patient. If you were able to get on a long acting med that worked for you I am quite certain that you will be able to retun to the 15mg oxycodone. It's not as of you were taking 30 or 40mg of oxycodone at a time hoping to switch back to 10 or 15. You are talking about a 5mg reduction that hopefully could be covered by the ER Meds.

Yes, though, one company (KVK Tech) makes 20mg immediate release oxycodone, but would probably have to be ordered specially by the pharmacy.

Believe me, snorting oxymorphone will invariably cause a persons tolerance to opioids to SKYROCKET. this is not a good thing you are doing for a variety of reasons, but I can assure you it will not take long until 15mg of oxycodone is like eating a skittle... And it's not going to be because of the Percocet, it will be because of the oxymorphone. It is for this reason I really think you need to find someone who actually listens to what you're telling them, and frankly I find it somewhat odd your doctor is so adamant about keeping you on the oxymorphone. Most PM docs would likely be thrilled to take someone off such a strong painkiller voluntarily.

Anyway, that's my take on this. Sorry if it seems blunt or anything, I'm just short on time and posting on my phone. I completely understand your situation because I've been there before, and nothing about this seems right to me.

I agree with BAzing's excellent advice. Talk to your friend's friend's doctor (phew) one more time about getting the proper long-acting dose of medication that will cover your pain, and if he doesn't listen and act, it's time to find a new doc. Meanwhile, please don't insufflate the oxycodone because it will definitely raise you tolerance, no matter what.